Patients with Obstructive Sleep Apnea for Ambulatory Surgery: Challenges and Management

Obstructive sleep apnea (OSA) is a common breathing disorder, which is of particular concern to anesthesiologists, as it is associated with increased perioperative complications. Although the suitability of ambulatory surgery in OSA patients remains controversial, patients with high burden of comorbidities, particularly those with poorly stabilized medical conditions are not suitable for ambulatory surgery. Risk reduction strategy would include routine preoperative screening for OSA as well as approaches to minimize reliance on opioids and achieve rapid clear-headed recovery from anesthesia. Developing and implementing protocols (clinical pathways) allow for uniform practice, which can improve safety and efficiency. This requires a multidisciplinary approach in which the anesthesiologist should take a lead in collaborating with the surgeons and perioperative nurses. This article will discuss the current evidence related to selection and management of OSA patients scheduled for surgery in an ambulatory setting.